日本发作性睡病或特发性嗜睡症患者原发性头痛及梦呓行为的患病率和特征：一项多中心横断面研究
The Prevalence and Characteristics of Primary Headache and Dream-Enacting Behaviour in Japanese Patients with Narcolepsy or Idiopathic Hypersomnia: A Multi-Centre Cross-Sectional Study.
作者信息
Suzuki Keisuke, Miyamoto Masayuki, Miyamoto Tomoyuki, Inoue Yuichi, Matsui Kentaro, Nishida Shingo, Hayashida Kenichi, Usui Akira, Ueki Yoichiro, Nakamura Masaki, Murata Momoyo, Numao Ayaka, Watanabe Yuji, Suzuki Shiho, Hirata Koichi
机构信息
Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
School of Nursing, Dokkyo Medical University, Tochigi, Japan.
出版信息
PLoS One. 2015 Sep 29;10(9):e0139229. doi: 10.1371/journal.pone.0139229. eCollection 2015.
BACKGROUND
Because the prevalence and characteristics of primary headache have yet to be thoroughly studied in patients with hypersomnia disorders, including narcolepsy and idiopathic hypersomnia, we examined these parameters in the Japanese population.
METHODS
In a multicentre cross-sectional survey, among 576 consecutive outpatients with sleep disorders, 68 narcolepsy patients and 35 idiopathic hypersomnia patients were included. Additionally, 61 healthy control subjects participated. Semi-structured headache questionnaires were administered to all participants.
RESULTS
The patients with narcolepsy (52.9%) and idiopathic hypersomnia (77.1%) more frequently experienced headache than the healthy controls (24.6%; p<0.0001). The prevalence rates were 23.5%, 41.2% and 4.9% for migraine (p<0.0001) and 16.2%, 23.5% and 14.8% (p = 0.58) for tension-type headache among the narcolepsy patients, the idiopathic hypersomnia patients and the control subjects, respectively. Those who experienced migraine more frequently experienced excessive daytime sleepiness, defined as an Epworth Sleepiness Scale score of ≥10, than those who did not experience headache among the patients with narcolepsy (93.8% vs. 65.6%, p = 0.040) and idiopathic hypersomnia (86.7% vs. 37.5%, p = 0.026). Dream-enacting behaviour (DEB), as evaluated by the rapid eye movement sleep disorders questionnaire, was more frequently observed in the narcolepsy patients than in the idiopathic hypersomnia patients and the control subjects. An increased DEB frequency was observed in the narcolepsy patients with migraines compared to those without headache.
CONCLUSIONS
Migraines were frequently observed in patients with narcolepsy and idiopathic hypersomnia. DEB is a characteristic of narcolepsy patients. Further studies are required to assess the factors that contribute to migraines in narcolepsy and idiopathic hypersomnia patients.
背景
由于原发性头痛的患病率和特征在发作性睡病和特发性嗜睡症等发作性睡病障碍患者中尚未得到充分研究，我们在日本人群中对这些参数进行了研究。
方法
在一项多中心横断面调查中，纳入了576例连续的睡眠障碍门诊患者，其中包括68例发作性睡病患者和35例特发性嗜睡症患者。此外，61名健康对照者也参与其中。对所有参与者进行了半结构化头痛问卷调查。
结果
发作性睡病患者（52.9%）和特发性嗜睡症患者（77.1%）比健康对照者（24.6%；p<0.0001）更频繁地经历头痛。发作性睡病患者、特发性嗜睡症患者和对照者中偏头痛的患病率分别为23.5%、41.2%和4.9%（p<0.0001），紧张型头痛的患病率分别为16.2%、23.5%和14.8%（p = 0.58）。在发作性睡病患者和特发性嗜睡症患者中，经历偏头痛的患者比未经历头痛的患者更频繁地出现日间过度嗜睡，定义为埃普沃思嗜睡量表评分≥10（发作性睡病患者中分别为93.8%对65.6%，p = 0.040；特发性嗜睡症患者中分别为86.7%对37.5%，p = 0.026）。通过快速眼动睡眠障碍问卷评估的梦呓行为（DEB）在发作性睡病患者中比在特发性嗜睡症患者和对照者中更频繁地被观察到。与无头痛的发作性睡病患者相比，有偏头痛的发作性睡病患者中DEB频率增加。
结论
在发作性睡病和特发性嗜睡症患者中经常观察到偏头痛。DEB是发作性睡病患者的一个特征。需要进一步研究以评估导致发作性睡病和特发性嗜睡症患者偏头痛的因素。
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